Diagnosing Lameness

Question 1

An alteration of the normal gait pattern caused by a functional or structural disorder in the locomotor system

Answer 1

Lameness

Question 2

What abnormality causes lameness?

Answer 2

Pain

Question 3

What are the 7 classic steps of a lameness exam?

Answer 3

History, PE, palpation, observation @ exercise, flexion tests, nerve blocks, DI

Question 4

What is the primary goal of a lameness exam?

Answer 4

Localization and diagnosis

Question 5

What can cause asymmetry?

Answer 5

Nerve damage, muscle atrophy/wasting

Question 6

Depending on what the horse does for a living, what % of lameness problems occur in the foot?

Answer 6

80%

Question 7

What gait is the lameness graded from?

Answer 7

Trot

Question 8

What is the best surface for evaluation?

Answer 8

Firm and even

Question 9

What kind of suface can help dx neuro disease?

Answer 9

Soft sand, hills/incline

Question 10

Is it easier to ID lameness in the forelimb or hindlimb?

Answer 10

Forelimb

Question 11

When the painful limb hist the ground, what direction does the head go?

Answer 11

Up

Question 12

What point do you watch on the hindlimb to dx lameness?

Answer 12

Point of the hips

Question 13

You will see ______ gluteal excursion in the lame limb

Answer 13

Increased

Question 14

If the hindlimb lameness is 3/5 or above, the horse will appear to have what other lameness?

Answer 14

Ipsilateral forelimb

Question 15

Pressure point is smaller and has shorter handles for easier handling

Answer 15

Adjustable hoof testers

Question 16

Where do you use hoof testers?

Answer 16

Wall, sole, frog, heels, coronary band

Question 17

Difficult to observe, inconsistent lameness

Answer 17

Grade 1

Question 18

Lameness may only be evident when the horse is asked to work

Answer 18

Grade 1

Question 19

Lameness difficult to observe in a straight line but consistently apparent under certain circumstances (circling, hard surface, incline)

Answer 19

Grade 2

Question 20

Lameness is consistently observable at a trot under all circumstances

Answer 20

Grade 3

Question 21

Obvious lameness w/marked head not, hitching, shortened stride

Answer 21

Grade 4

Question 22

Minimal weight bearing/non-weight bearing and inability to move

Answer 22

Grade 5

Question 23

Lameness seen with fractures and foot abscesses

Answer 23

Grade 5

Question 24

What 5 pathognomonic lamenesses are diagnosed at the walk?

Answer 24

Peroneus tertius rupture, locking patella, stringhalt, fibrotic myopathy, sweeny

Question 25

How does locking patella happen?

Answer 25

Weak quads can't unlock stay apparatus

Question 26

How does the peroneus tertius work as part of the stay apparatus?

Answer 26

When the hock flexes, the stifle flexes

Question 27

Hock extended w/flexed stifle, dimple on the back of the limb w/acute rupture

Answer 27

Peroneus tertius rupture

Question 28

Why do you not want to give NSAIDs post-op locking patella surgery?

Answer 28

Encourage inflammatory response at site to strengthen the ligament

Question 29

Foot slapping sound when affected food hits ground

Answer 29

Fibrotic myopathy

Question 30

Thickening in semimembranosus/tendinosis muscles from trauma to the mm belly

Answer 30

Fibrotic myopathy

Question 31

Depending on the extent of the injury, a lot of these horses can go back to work but they will likely never have a normal gait again

Answer 31

Fibrotic myopathy

Question 32

Rapid muscle atrophy seen in shoulder of distance exam

Answer 32

Sweeny

Question 33

What nerve is damaged to result in sweeny?

Answer 33

Suprascapular nerve injury

Question 34

How is the suprascapular nerve injured?

Answer 34

Pressure against or trauma to the nerve

Question 35

Hyperflexion of the hind limbs (hock)

Answer 35

Stringhalt

Question 36

What two gait abnormalites could be confused for each other?

Answer 36

Stringhalt and intermittent patella locking

Question 37

When do you do flexion tests?

Answer 37

After palpation, observation at exercise, and hoof testers

Question 38

Trot off in a straight line immediately after flexion

Answer 38

Flexion tests

Question 39

What is a positive flexion test?

Answer 39

Worse lameness

Question 40

How do you do a flexion test for the distal forelimb?

Answer 40

30 sec flex

Question 41

How do you do a flexion test for the proximal forelimb?

Answer 41

60 sec flex of elbow, shoulder, carpus

Question 42

What demographic may show a false positive distal forelimb flexion test?

Answer 42

Normal young horse

Question 43

Flexion test for proximal hindlimb

Answer 43

Spavin test

Question 44

Is the spavin test hock specific?

Answer 44

No

Question 45

How do you do a spavin test?

Answer 45

90 sec flex hock, stifle, hip

Question 46

How do you use local anesthesia to localize a lameness?

Answer 46

Begin distally and work proximally